The smiley face, that symbol of empty-headed cheerfulness, is a visage no New Yorker (or happiness researcher, in fact) could love. So, in the following pages, several New York graphic designers offer their own riffs on the icon

They say you can’t really assign a number to happiness, but mine, it turns out, is 2.88. That’s not as bad as it sounds. I was being graded on a scale of 1 to 5. My score was below average for my age, education level, gender, and occupation, sure, but at exactly the 50 percent mark for my Zip Code. Liking my job probably helped, being an atheist did not, and neither did my own brain chemistry, which, in spite of my best efforts to improve it, remains more acidic than I’d like. Unhappy thoughts can find surprisingly little resistance up there, as if they’ve found some wild river to run along, while everything else piles up along the banks.

The test I took was something called the Authentic Happiness Inventory, and the man who designed it, Chris Peterson, is one of the first people I meet at the Positive Psychology Center at the University of Pennsylvania. Unlike many who study happiness for a living, he seems to embody it, though he tells me that’s a recent development. He offers me an impromptu tour of the place (walls of salmon and plum and turquoise; tables piled high with complimentary granola bars), then wanders toward his office, absently hugging an orange-juice bottle to his stomach as he drifts, having graciously offered to check, at my request, which Zip Codes are the happiest and the most miserable in his 350,000-person database. At the end of the day, I check in with him.

The happiest, he reports, is Branson, Missouri’s.

“But please appreciate—and this is a formal disclaimer—that these are not representative respondents,” he says. “These are just people who logged on to our Website and took our happiness measure.” In other words, hundreds of mental patients from Chicago could have decided to take the test, while only fifteen Buddhists in Baja did the same, which would result in a very skewed perception of the well-being of Chicagoans and Bajans. I ask how many people from Branson took the test. “A small number,” he warns. “I think it was two or three. And the other happiest Zip Codes are also represented by a very small number of respondents. Nonetheless, I think the results are kind of interesting. Missoula, Montana. Rural Minnesota. Rural Indiana. Rural Alabama. Savannah, Georgia. The Outer Banks. Is there a theme here? There’s a theme here. It seems to run through the Bible Belt and go straight up north. And if you want to know the absolutely most miserable Zip Code—and this is based on a very large number of people—it seems to start with 101.”

That’s the prefix assigned to many of the office buildings in midtown Manhattan. “Staten Island is also miserable,” he adds.

So what does this say about New York? I ask.

“I don’t know,” he says. “Maybe that if you make it there, you can make it anywhere, but you won’t be happy doing it.”

This past spring, the Boston Globe reported that the single most popular course at Harvard was about positive psychology, or the study of well-being. Its immense appeal took everyone by surprise. Just one year before, the instructor, Tal Ben-Shahar, offered the course for the first time, and although it was certainly a hit, with 380 students enrolled, no one could have imagined that the following year the number would have jumped to 855.

There’s a theme here, too. Back in the mid-1840s, a Scot by the irresistible name of Samuel Smiles was invited to lecture before a class in “mutual improvement” in the north of England—a class, he later noted in a book, that also began with two or three young men but grew so large it took over a former cholera hospital. That book is called Self-Help, published in 1859. It is considered by many to be the first of its genre. Today, it’s still in print, and has even come up in Ben-Shahar’s Harvard class. He has tremendous respect for it.

“For many years,” says Ben-Shahar, “the people who were writing about happiness were the self-help gurus. It had a bad rap. It was all ‘five easy steps,’ rather than dignity and hard work. What I’m trying to do in my class is to regain respectability for the concept of self-help. It’s a great thing, if you think about it literally. It’s what this country was built on.”

The pursuit of happiness was indeed at the heart of America’s conception. But the study of happiness—as a science, with random-assignment, placebo-controlled testing—is a far more recent phenomenon. And right now, it’s booming. At least two basic positive-psychology textbooks are being published this fall, one written by Peterson, the other by a University of Kansas professor named Shane Lopez, whose publisher estimates that roughly 150 colleges will be offering some kind of positive-psychology course next year. Since 2000, the University of Erasmus at Rotterdam has been publishing the Journal of Happiness Studies (whose editorial board is represented in curious disproportion by Californians and Germans). At Barnes & Noble, there are three excellent books about happiness now sitting on the shelves: the divinely readable Stumbling on Happiness, by Harvard professor Daniel Gilbert, about how hopeless we are at predicting our moods; The Happiness Hypothesis, by University of Virginia professor Jonathan Haidt, about the ways that ancient wisdom about flourishing intersects with the modern; and Happiness: A History, an intellectually elegant work by historian Darrin McMahon, which is exactly as it sounds, but darker.

Ellen Langer, a professor at Harvard, ventures that the explosive interest in positive psychology is, like so many cultural curiosities involving self-obsession, a boomer phenomenon. “There’s a feeling of, ‘I’m not going off to some nursing home,’ ” she says. (And she should know: During the seventies, she found that the more control nursing-home patients had—over watering their plants, for example—the longer they were apt to live.) And there are undoubtedly other factors at work. Universities, for example, have become more sensitive today to the intense pressures on their students (at Harvard, the chief of mental-health services recently came out with a book called The College of the Overwhelmed). Economics has also started to take the discipline of psychology seriously again—Malcolm Gladwell’s books are a sure testimony to this—and the psychology of positivity and productivity were a perfect fit for the ethos of the bubble years. (Recently, I’ve come to wonder whether positive psychology isn’t also the perfect discipline for the era of George Bush, the decider, the man who remains shinily optimistic no matter how many red lights are glowing on his dashboard.)

BCEM vs. ABEM controversy: “Why Can’t We All Just Get Along?”
by James Meade, M.D., BCEM

I am a life member of ACEP, FCEP, the AMA and the FMA, as well as being a member the American Association of Physician Specialists, and certified by the Board of Certification in Emergency Medicine. However the following are my own personal views and not those of any organization that I belong to.

The continuing controversy over board certification ABEM v BCEM is counter productive and serves no good purpose. I find it baffling since we all have the same goals: to improve the practice of emergency medicine. The Florida Board of Medicine after a 3 year study, decided that “The American Association of Physician Specialists (which includes the board of Certification in Emergency Medicine) is a legitimate and bone fide organization … and …should be granted approval as a specialty recognizing agency’

This has been challenged 5 times by the FMA, FCEP and ACEP and the Board has confirmed its original decision in each case, even though the composition of the board has almost completely changed during that period. The FMA apparently gave up the battle, but FCEP has not. Other approaches have been tried, such as writing ABEM into the statutes. A short lived attempt was tried during the last session to require that EMS medical directors be emergency medicine residency trained. A hearing before an administrative law judge recently reaffirmed the decision of the Board of Medicine. All of these efforts have accomplished nothing and just waste time and money, on both sides which would be better spent elsewhere.

Dr Frederick Blum, past president of ACEP in a recent letter to the Section on Certification states “I understand why many of you sought certification with BCEM. In your position I would have done the very same thing. (Dr. Blum is not residency trained in Emergency Medicine). I will support your right to do so and your rights as members….and your ability to practice unfettered. My actions, and those of Dr Suter before, back those words up”.

Dr Brian Keaton, president of ACEP has stated that “Legacy physicians (that is emergency physicians who started practice before 2000) fill a valuable role and I commend those who strive to improve their ability to practice the highest quality emergency medicine. Preparing for and passing BCEM may be an excellent way to accomplish that end ACEP is on record as being supportive of this group of members.”

I believe that we have the same mission in mind: to improve the practice of emergency medicine. Now it is stated that all emergency physicians should be residency trained and ABEM certified… This is a utopian idea. Let us look at the numbers.

There are 23,818 members of ACEP as of March of this year, of which about 19,000 are ABEM Boarded, but not necessarily residency trained. Not all ABEM boarded physician belong to ACEP. The remaining 5000 are either BCEM or have other specialties certifications. There are about 32000 full time equivalents practicing emergency medicine in the USA. According to the most recent workforce study. That means that there are about 13000 non ABEM certified physicians practicing, some of whom are not boarded in any specialty.

Last year there were 154 emergency programs with 1,244 graduates of EM residencies in the United States; this year there will be 1,251. That means it will take 10 years before there are enough ABEM boarded (not all of whom have EM residencies) to fill all of the available positions. Although there are a number of new programs who are coming on line, their contribution will be small in relation the total number, and we still have not factored in the attrition rate which about equals the number of new graduates. For instance The Sterns survey found that 40% of emergency physician have considered leaving the field due to mal practice and other concerns. In Florida last year over half of the graduates form Florida EM Residencies promptly left after graduation this year and went to less stressful environments.

It will be well over 12 years before we have enough residency trained physician to completely cover the available positions. What we should concentrate on at this time is to improve the status of that non residency trained who are training in other specialties

In reviewing disciplinary cases that come before the board, I see no correlation between doctors who have failed to meet the standard of care and board certification.

What we are trying to do at the Board of Certification of Emergency Medicine is to improve the practice of this specialty by setting up rigorous standards to certify those physicians who do not qualify for ABEM and who cannot take a residency.